As the saying goes, it’s a medicine with three dangers. So have you found out what dangers exist in the medicine you usually take? Eat what is not to take medicine? Here we go together to see. Disulfiram (disulfiram) is the common name for the withdrawal of alcohol sulfur drugs, also known as withdrawal of alcohol sulfur, disulfiram wake, is a treatment of chronic ethanol poisoning and ethanol toxic psychosis, as a withdrawal drug has been used in many countries. Application of this drug after drinking alcohol will be nausea, vomiting, fear and other serious reactions, and the alcoholic fear of drinking alcohol, so as to play a role in alcohol withdrawal. However, the chemical structure or mechanism of action of certain drugs currently used in clinical practice is similar to that of disulfiram, which can produce disulfiram-like reactions, also known as antabuse reactions. Disulfiram-like reaction characteristics 1, the clinical characteristics of the disulfiram-like reaction use of drugs that can cause disulfiram-like reaction within a week after drinking alcohol, can appear facial and general skin flushing, conjunctival redness, fever, dry mouth, dizziness, headache, dizziness, panic, chest tightness, shortness of breath, sweating, dyspnea, nausea and vomiting, confused speech, speech, blurred vision, unsteady gait, frenzy, delirium, impaired consciousness, syncope The symptoms include abdominal pain, diarrhea, throat tingling, tremor, garlic odor in the mouth, tachycardia, decreased blood pressure, irritability, panic and fear, near-death feeling, and in some cases, confusion, numbness of the limbs, incontinence, and in severe cases, shock, convulsions, acute heart failure, acute liver damage, angina pectoris, myocardial infarction, and even death. This performance is related to the inhibition of acetaldehyde dehydrogenase and dopamine β-aldolase in the body by disulfiram, and the performance of this group of clinical syndrome is called disulfiram-like reactions. 2, the time characteristics of the disulfiram-like reaction use of disulfiram-like reaction of drugs after drinking alcohol, can be as early as 5min that symptoms, generally more in 30min, a few in lh, rarely in 1h after the appearance of disulfiram-like reaction. After the application of drugs that can cause disulfiram-like reactions in pediatric patients, alcohol or food containing ethanol should be avoided for 2 to 3 weeks after the drug is discontinued, because the function of the liver in metabolizing ethanol in pediatric patients is poor, and such reactions can occur even at low concentrations of ethanol. There is individual variability in disulfiram-like reactions. Xie Fang reported that disulfiram-like reactions may occur in children with a history of alcohol consumption 3 d before drug administration. Chen Ling reported a disulfiram-like reaction in a 2-year-old child 0.5 h after taking 10 mL of Huoxiang Zhengqi water. 3, the characteristics of disulfiram-like reaction and the type and amount of alcohol consumption disulfiram-like reaction is proportional to the dose of the drug used, the interval after stopping the drug and the amount of alcohol consumption, and the relationship with the type of alcohol consumption is not clear. There are reports of disulfiram-like reactions after drinking 50mL of beer. White wine, red wine, yellow wine, beer and beverages containing ethanol can all cause disulfiram-like reactions. When disulfiram-like reactions occur, they often last for about 2h and gradually resolve, but in severe cases, they can last for 24h or several days before they are completely relieved. Diagnostic criteria, grading and differential diagnosis 1, diagnostic criteria There is a clear history of the use of drugs that can cause disulfiram-like reactions; the use of ethanol and its products 0d-7d after the use of drugs, or the use of drugs that can cause disulfiram-like reactions after drinking alcohol; ethanol-based drugs and drugs that can cause disulfiram-like reactions are applied at the same time; there are typical clinical manifestations of disulfiram-like reactions; the amount of alcohol consumed or the degree of alcohol are significantly The amount or degree of alcohol consumed is significantly smaller or lower than the usual amount or degree of alcohol consumed, but significantly different from the usual intoxication; no history of allergy to ethanol and the use of such drugs: in the case of disulfiram-like reactions, if there are no related diseases, the blood routine, blood sugar, renal function, electrolytes, cardiac enzyme spectrum, chest X-ray are mostly abnormal. 2.Disulfiram-like reactions are graded as mild: flushing of the skin on the face or body. Mild dizziness, panic, no nausea, vomiting, fever, headache, etc.; moderate: dizziness, headache, panic, nausea, vomiting, fever, but no chest pain, respiratory distress, shock; severe: chest pain, respiratory distress, shock, even impaired consciousness, incontinence. Treatment of disulfiram-like reaction Disulfiram-like reaction is a pharmacogenic emergency and needs to be given active treatment. 1, in situ treatment Immediately stop drinking, induce vomiting, and gastric lavage when available. Keep the airway open, remove oral and nasal vomit and secretions. Head to the side to prevent asphyxia caused by vomit blocking the airway. 2. General treatment: Administer oxygen, rest in bed, observe vital signs, measure blood pressure, pulse and respiration. Check electrocardiogram or electrocardiographic monitoring and observe pulse oximetry, and conduct necessary auxiliary examinations. 3.Medication Establish intravenous access, give intravenous drip of 5%-10% glucose 500mL-1000mL, add vitamin C2g-4g, vitamin B6 0.2g-0.4g, dexamethasone 5mg-10mg, which can accelerate the oxidation of ethanol. Intravenous injection and drip naloxone 0.4mg-0.8mg can antagonize the effect of ethanol. H2 receptor blockers, antihistamines can improve the symptoms. 4, symptomatic treatment with chest tightness, angina application of nitrate drugs; shock should be supplemented with fluids or dobutamine and other antihypertensive drugs; blood activation drugs used; vomiting can be used gastric complex. If there are serious complications, active and effective resuscitation should be given to prevent more serious consequences of disulfiram-like reactions. Table 1: Drugs that can cause disulfiram reaction Table 2: Drugs containing alcohol